Provider Demographics
NPI:1659300911
Name:PREFERRED HOSPITAL LEASING ELDORADO, INC.
Entity Type:Organization
Organization Name:PREFERRED HOSPITAL LEASING ELDORADO, INC.
Other - Org Name:SCHLEICHER COUNTY MEDICAL CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:A
Authorized Official - Last Name:FREEMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:405-878-0202
Mailing Address - Street 1:102 N US HIGHWAY 277
Mailing Address - Street 2:P.O. BOX V
Mailing Address - City:ELDORADO
Mailing Address - State:TX
Mailing Address - Zip Code:76936-4010
Mailing Address - Country:US
Mailing Address - Phone:325-853-2507
Mailing Address - Fax:
Practice Address - Street 1:102 N. NORTH US HIGHWAY 277
Practice Address - Street 2:
Practice Address - City:ELDORADO
Practice Address - State:TX
Practice Address - Zip Code:76936-1246
Practice Address - Country:US
Practice Address - Phone:325-853-2507
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-30
Last Update Date:2014-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX008340314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX45Z304Medicare Oscar/Certification